Behavior Problems

and Behavioral Disorders

How can you tell if your teen's behavior is a problem?

Could it be just 'normal teenage rebellion'?

Is it a behavioral disorder such as Oppositional Defiant Disorder (ODD), a pattern of negative, defiant and disobedient behavior, or Conduct Disorder, where your child repeatedly and persistently violates rules and the rights of others without concern or empathy?

Perhaps the most important questions for parents to consider are,

How much distress, disruption, and heartache are your child's problems causing?

How are your child's problems affecting the family, your marriage, you, the child himself/herself?

The Diagnostic and Statistical Manual of Mental Health Disorders, Fourth Edition, Text Revision of the American Psychiatric Association defines oppositional defiant disorder (ODD) as a recurrent pattern of negativistic, defiant, disobedient, and hostile behavior toward authority figures that persists for at least 6 months.

Behaviors included in the definition are the following:

• losing one’s temper

• arguing with adults

• actively defying requests

• refusing to follow rules

• deliberately annoying other people

• blaming others for one's own mistakes or misbehavior

• being touchy, easily annoyed or angered, resentful, spiteful, or vindictive.

ODD is usually diagnosed when a child has a persistent or consistent pattern of disobedience and hostility toward parents, teachers, or other adults.  The primary behavioral difficulty is the consistent pattern of refusing to follow commands or requests by adults.

Children with ODD often are

• stubborn

• test limits and push boundaries

• easily annoyed

• lose their temper

• argue with adults

• refuse to comply with rules and directions

• blame others for their mistakes.

The criteria for ODD are met only when the problem behaviors occur more frequently in the child than in other children of the same age and developmental level.  These behaviors cause significant difficulties with family and friends, and the oppositional behaviors are the same both at home and in school.  Sometimes, ODD may be a precursor of a conduct disorder. 

Risk factors for teen behavior problems include:

• Family conflict

• Academic failure in elementary school

• Friends who engage in alcohol and drug use, delinquent behavior, violence, or other problem behaviors

• Peer rejection

• Family history of a problem behavior

• Favorable parental attitudes to problem behavior

• Witnessing family violence

Family instability, including economic stress, parental mental illness, harshly punitive behaviors, inconsistent parenting practices, multiple moves, and divorce may also contribute to the development of oppositional and defiant behaviors.

ODD is not diagnosed if the problematic behaviors occur exclusively with a mood or psychotic disorder.

The following interventions have been used to help replace defiant, oppositional behavior with responsible behavior:

• Family and individual counseling to determine underlying issues and learn strategies for behavior change.

• Parenting support groups to help guide and empower parents.

• Parenting classes to help learn ways of providing consistency, structure, and a positive, less stressful home environment.

• A strong and positive working relationship between parents and teachers.

In addition, the following parenting strategies are helpful:

• Listening to your teen.  Listening and valuing adolescent ideas is what promotes the ability of parents to effectively communicate with them. Most parents do not listen well because they are too busy -- with work, community, church, and home responsibilities.  Listening to a teen does not mean giving advice and attempting to correct the situation.

• Talking about morals and ethical behavior.  Passing along a strong sense of values is one of the fundamental tasks of being a parent.  Parents need to talk to their children about what is right and wrong and about appropriate and inappropriate behavior.

• Dealing with what is important.  Don't make a fuss about issues that are reversible or don't directly threaten your child's or another person's safety. These issues include unwashed hair, a messy room, torn jeans, etc.  Save your thunder for more important concerns.  Safety is a non-negotiable issue. Safety rules need to be stated clearly and enforced consistently. 

• Being consistent and holding your ground.  There will be times when adolescents won't like what you say or will act as though they don't like you.  Being your teen's friend should not be your primary role during this time of their lives.  It's important to resist the urge to win their favor or try too hard to please them.

• Avoiding arguments.  Arguing only fuels hostility and it doesn't get you heard.  Don't feel obliged to judge everything your teen says.  Retain the mutual right to disagree.  Never try to reason with someone who is upset -- it is futile.  Wait until tempers have cooled off before trying to sort out a disagreement.  Don't try to talk teens out of their feelings.  You can acknowledge someone's reaction without condoning it.  This type of response often defuses anger.